126 sedentary women (44±12 yr, 44.8±5% body fat, 35.4±6 kg/m2) were randomized to participate in a no diet or exercise control group (C) or the Curves Complete ® 90‐day Challenge (CC), Weight Watchers ® Points Plus (WW), Jenny Craig ® (JC), or Nutrisystem ® Advance Select™ (NS) weight loss programs for 12‐wks. Self‐reported diet quality was assessed on a 0–10 point Likert scale at 0, 4, 8, and 12‐wks. Data were analyzed by MANOVA and are presented as percent changes after 12‐wks. No significant interactions were seen among groups in changes in appetite (C − 12.2±20; CC −4.0±41; WW −1.6±50; JC −14.3±27; NS −3.1±33 %, p=0.69), hunger (C −16.3±31; CC −1.2±47; WW 10.4±52; JC − 0.9±47; NS 10.6±88 %, p=0.48), satisfaction with food (C −3.8±49; CC 4.3±33; WW 0.8±26; JC −3.0±34; NS 0.7±33 %, p=0.93), feelings of fullness (C −0.3±32; CC −1.1±29; WW −5.3±21; JC − 10.7±37; NS 1.4±46 %, p=0.76), or general feelings of energy (C 19.4±67; CC 55.3±67; WW 56.8±88; JC 28.4±56; NS 38.9±59 %, p=0.23). Mean changes in diet quality were greater in the CC and JC groups compared to control (C 2.2±40; CC 86±79; WW 58±68; JC 99±158; NS 64±92 %, p=0.02). Results reveal that participants generally perceived satisfaction with the diets and that diet quality was significantly better in the CC and JC diet groups compared to a non‐diet controls. Supported by Curves International (Waco, TX)
48 sedentary women (44.8±10 yr, 44.8±4% body fat, 33.9±6 kg/m2) were randomized to participate in the Curves Complete® weight loss and exercise program for 12‐wks with (CC‐OS) and without (CC‐NS) online support that provided access to meal plans and progress monitoring. Fasting blood samples were obtained at 0, 4, 8, & 12 wks and analyzed by MANOVA. Data are presented as changes from baseline after 4, 8, and 12 wks for the CC‐OS and CC‐NS groups, respectively. Overall MANOVA analysis revealed a significant time (p=0.001) difference with no significant group × time effects (p=0.57). Univariate analysis revealed significant time effects for TG, CHL, HDL, and LDL and that participants in the CC‐OS group experienced greater changes in TG (CC‐OS − 27.1±21, −24.2±24, −23.2±20; CC‐NS 0.9±29, −6.1±22, −6.7±26 %, p=0.001) with no differences observed among groups in total CHL (CC‐OS −11.8±11, −9.1±9, −7.5±11; CC‐NS −6.0±10, −4.0±11, − 3.6±10 %, p=0.17), HDLc (CC‐OS −0.8±11, 0.3±11, 5.0±15; CCNS −3.4±9, −0.1±13, 2.5±15 %, p=0.78), LDLc (CC‐OS −11.1±15, − 9.2±13, −7.8±19; CC‐NS −7.4±15, −6.6±16, −4.7±11 %, p=0.83) or blood glucose (CC‐OS −2.2±10, −1.9±8, −2.4±12; CC‐NS 1.2±14, 1.6±12, −0.6±15 %, p=0.75). Results indicate that adding online access to meal plans and monitoring can promote more favorable changes in TG during a structured weight loss program with resistance‐based exercise.
Objective Commercial weight loss programs offer consumers a pre‐programmed means of managing weight. However, such programs differ in dietary advice and physical activity recommendations. The aim of this investigation was compare the Curves ® Complete 90‐day Challenge (CC), Weight Watchers ® Points Plus (WW), Jenny Craig ® At Home (JC), and Nutrisystem ® Advance Select™ (NS) on metabolic syndrome (MetS) and weight loss. Methods We examined 133 sedentary overweight women (47±11 yr, 86±14 kg, 35.4±6 kg/m 2 ) randomized into CC (n=29), WW (n=29), JC (n=27), NS (n=28), or control (n=20) for 12‐wks. Body mass and MetS were obtained at baseline and follow‐up (12 w). The primary outcome was MetS expressed as a categorical variable and summed z‐score (zMetS) as a continuous variable. Secondary outcomes included total caloric intake, body mass, respective anthropometry and measured physical activity (PA). Data were analyzed using a chi‐square and general linear model covaried for age and prevalence of MetS at baseline. Data are mean ± SD and mean change ± 95% CI when applicable. Results We observed significant reductions in total energy intake for all treatment groups except Control (−103 kcal, 95% CI, −277, 70): CC (−413 kcal, 95% CI, −573, −254), WW (−531 kcals, 95% CI, −675, −387), JC (−604 kcal, 95% CI, −753, −455), NS (−631 kcal, 95% CI, −778, −485). While post‐hoc analysis showed JC and NS to be greater than CC, weight loss was similar for all groups (−4.0 ± 4.2 kg). At baseline, the prevalence of MetS was: CC (35%), WW (31%), JC (37%), NS (39%) and control (45%). At follow‐up we observed a significant trend (p=0.008) in reduction of MetS prevalence such that CC (14%) and WW (28%) was significantly lower than JC (42%), NS (50%) and control (55%); however, WW was not significantly different than JC, NS, or control. When expressed as zMetS, only the CC group demonstrated a significant reduction in zMetS (−0.11, 95% CI −0.21, −0.004) vs. WW (−0.89, 95% CI −0.18, 0.02), JC (−0.05, 95% CI −0.16, −.06), NS (−0.06, 95% CI −0.16, 0.05) and control (−0.05, 95% CI, −0.18, 0.07). Other than exercise contained within the CC program, no significant changes were otherwise noted in total PA for any treatment group: CC (4645 MET min/week; 95% CI, −1638, 10929), Weight Watchers (−3361 MET min/week; 95% CI, 3208, 2988), Jenny Craig (−448 MET min/week; 95% CI, −6949, 6053), Nutrisystem (−967 MET min/week; 95% CI, −7401, 5468) or Control (5128 MET min/week; 95% CI, −2529, 12785). Conclusions Notwithstanding the minor differences in energy intake favoring JC and NS, each program demonstrated similar amounts of weight loss. However, a significant reduction in MetS was demonstrated only in CC and WW via categorical analysis and CC via zMetS. Thus, despite recommendations by each program to increase PA, the program including a structured fitness routine in conjunction with diet exhibited the greatest impact on changes in MetS. Support or Funding Information Curves International
41 sedentary women (55.3±10 yr, 45.0±4% body fat, 33.7±5 kg/m 2 ) were randomized to participate in a control group (C) or the Curves Complete ® (CC) weight loss and circuit resistance‐exercise program for 12‐wks. Participants in the CC program followed an energy‐restricted diet (30% C, 45% P, and 25% F) while participating in a circuit resistance‐training (3 d/wk) and walking (30 min, 3/d wk) program. Body mass, DEXA body composition, and resting energy expenditure (REE) measurements were obtained at 0, 4, 8, & 12 wks and analyzed by MANOVA. Data are presented as changes from baseline after 4, 8, and 12 wks for the C and CC groups, respectively. Participants in the CC program lost significant amounts of body mass (C −0.05±1.6, −0.1±2.2, 0.1±3.1; CC −2.1±1.7, −3.1±2.6, −3.9±3.2, kg, p=0.001), fat mass (C − 0.0±2.2, 0.2±2.3, −0.0±2.0; CC −2.2±1.4, −2.8±2.0, −4.1±2.4 kg, p=0.001) and body fat (C 0.1±1.7, 0.3±1.7, −0.1±1.7; CC −1.8±2.1, −2.2±2.3, −3.5±2.5 %, p=0.001) than controls with no time (p=0.54) or group × time effects on FFM (C −0.1±1.4, −0.1±1.7, 0.1±2.3; CC 0.2±1.8, 0.1±1.9, 0.5±1.6 kg, p=0.89). REE tended to differ among groups (C −20±149, 17±180, 39±190; CC −30±140, −65±169, − 85±130, kcal/d, p=0.03). Results indicate that post‐menopausal women who participate in an energy deficit higher protein and low fat diet with resistance‐exercise can promote fat loss without loss of FFM.
51 sedentary women (44.5±10 yr, 44.9±4% body fat, 34.0±6 kg/m 2 ) were randomized to participate in the Curves Complete ® weight loss and exercise program for 12‐wks with (CC‐OS) and without (CC‐NS) online support that provided access to meal plans and progress monitoring. Body mass, DEXA body composition, and resting energy expenditure (REE) measurements were obtained at 0, 4, 8, & 12 wks and analyzed by MANOVA. Data are presented as changes from baseline after 4, 8, and 12 wks for the CC‐OS and CC‐NS groups, respectively. Overall MANOVA revealed that both groups experienced improvements in body composition with minimal effects on REE. An overall significant interaction was observed among groups (p=0.02). Participants in the CC‐OS group tended to experience more favorable changes in body mass (CC‐OS − 2.6±1.3, −4.8±2.3, −6.2±3.3; CC‐NS −2.2±1.9, −3.5±3.1, −4.3±4.3 kg, p=0.08) and fat mass (CC‐OS −1.8±1.8, −3.5±2.3, −5.2±2.9; CC‐NS −2.0±2.4, −3.4±2.8, −3.8±4.0 kg, p=0.11), while FFM was preserved to a greater degree in the CC‐NS group (CC‐OS − 0.8±1.6, −1.2±2.1, −0.8±2.5; CC‐NS 0.0±1.5, 0.2±1.6, −0.2±2.0 kg, p=0.05). No significant differences were seen among groups in percent body fat (CC‐OS −0.9±1.8, −1.9±2.4, −3.3±2.3; CC‐NS − 1.5±2.3, −2.5±2.5, −2.7±3.4 %, p=0.21) or REE (CC‐OS −47±144, − 23±176, 0.4±154; CC‐NS −83±174, −65±184, −102±170 kcals/d, p=0.16). Results indicate that adding online access to meal plans and monitoring can promote more favorable changes in body composition while maintaining REE.
Resistin and visfatin are secreted by adipose tissue and potential regulators of inflammation and insulin sensitivity. This study examined the effects of exercise and diet‐induced weight loss on resistin, visfatin and other adiposity and inflammatory markers. 26 sedentary obese women were randomly assigned into a control (C) or an exercise (E) group that involved circuit resistance‐exercise (4 d/wk) with walking (10,000 steps/d, 3 d/wk) while consuming 1,200 kcal/day for 1‐wk and 1,500 kcal/d diet for 11 wks consisting of 45:30 % PRO:CHO. Baseline and post‐training DEXA body composition and fasting blood samples were obtained and analyzed by MANOVA and Pearson correlation analysis. Data are presented as mean±SD changes from baseline. Participants in the E group lost more weight (E: ‐13.0±8.9; C: ‐1.4±3.1 lbs, p=0.001) and fat (E: ‐5.1±4.5; C:‐0.4±1.5 kg, p=0.001). Significant differences were seen between groups in leptin (E: ‐19.8±21.9; C: 4.5±16 ng/ml, p=0.003) while visfatin (E: ‐0.09±15.4; C: 89.3±177 ng/ml, p=0.095), IL‐6 (E: ‐38.9±46; C:264.4±597 %, p=0.093), TNF‐α (E: 1.57±28; C: 96.9±186 %, p=0.093), and insulin (E: ‐8.5±14.9; C:0.12±7.7 uIU/ml, p=0.070) tended to differ between groups and no differences were seen in resistin (E: 5.7±126; C: ‐62.3±162 ng/ml, p=0.25) or glucose (E: ‐3.8±19.8; C:‐2.8±6.9 %, p=0.87). Significant correlations were seen between changes in resistin and TNF‐α (r = ‐0.49) while changes in visfatin correlated with changes in leptin (r=0.51) and IL6 (r=0.91). These findings indicate that exercise has beneficial effects on weight loss and body composition and this may adiposity and inflammatory markers.
Objective: To determine whether sedentary obese women with elevated levels of homeostatic model assessment (HOMA) insulin resistance (ie, > 3.5) experience greater benefits from an exercise + higher-carbohydrate (HC) or carbohydrate-restricted weight loss program than women with lower HOMA levels. Methods: 221 women (age, 46.5 ± 12 years; body weight, 90.3 ± 16 kg; body mass index, 33.8 ± 5 kg/m2) participated in a 10-week supervised exercise and weight loss program. The fitness program involved 30 minutes of circuit-style resistance training 3 days per week. Subjects were prescribed low-fat (30%) isoenergetic diets that consisted of 1200 kcals per day for 1 week (phase 1) and 1600 kcals per day for 9 weeks (phase 2) with HC or higher protein (HP). Fasting blood samples, body composition, anthropometry, resting energy expenditure, and fitness measurements were obtained at 0 and 10 weeks. Subjects were retrospectively stratified into lower (LH) or higher (HH) than 3.5 HOMA groups. Data were analyzed by multivariate analysis of variance with repeated measures and are presented as mean ± standard deviation changes from baseline. Results: Baseline HOMA levels in the LH group were significantly lower than those in the HH group (LH, 0.6 ± 0.7; HH, 6.3 ± 3.4; P = 0.001). Diet and training significantly decreased body weight (−3.5 ± 3 kg), fat mass (−2.7 ± 3 kg), blood glucose (−3%), total cholesterol (−4.5%), low-density lipoproteins (−5%), triglycerides (−5.9%), systolic blood pressure (−2.6%), and waist circumference (−3.7%), while increasing peak aerobic capacity (7.3%). Subjects in the HP group experienced greater weight loss (−4.4 ± 3.6 kg vs −2.6 ± 2.9 kg), fat loss (−3.4 ± 2.7 kg vs −1.7 ± 2.0 kg), reductions in serum glucose (3% vs 2%), and decreases in serum leptin levels (−30.8% vs −10.8%) than those in the HC group. Participants in the HH (−14.1%) and HP-HH (−21.6%) groups observed the greatest reduction in serum blood glucose. Conclusion: A carbohydrate-restricted diet promoted more favorable changes in weight loss, fat loss, and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate. Additionally, obese women who initiated training and dieting with higher HOMA levels experienced greater reductions in blood glucose following an HP diet.
Leptin, a hormone secreted by adipose tissue, is used to measure energy stores, which in turns helps in the regulation of metabolism. Obese individuals tend to have higher leptin levels, partially because of their increased stores of adipose tissue. In addition to fat mass, leptin levels continue to be evaluated for its relationships with other variables related to health and obesity. PURPOSE: The purpose of this investigation was to compare baseline leptin levels to other markers of health, metabolism and bone in sedentary obese women. METHODS: 450 sedentary women (44.0±12 yrs; 202.68 ± 37.7 lbs; 44±5 % fat) were included in this study. Participants underwent a baseline testing session prior to starting a diet and exercise program. The testing included DEXA body composition, body mass, resting blood pressure and heart rates, resting energy expenditure (REE), fasting blood samples to analyze for various metabolic markers, and a maximal graded exercise test on the treadmill. Data was analyzed by Pearson product bivariate correlational analysis and is reported as the mean ± SD along with the correlation coefficient. RESULTS: Baseline leptin levels (91.4 ± 73.9 ng/mL) were positively correlated with body weight (202.7±37.5 lbs, r=0.40), BMI (34.5±5.9, r=0.39) waist circumference (39.0±5.2 in, r=0.36), fat mass (37.3±9.6 kg, r=0.33), fat free mass (46.3±4.2 kg, r=0.18), percent body fat (48.1±5.3%, r=0.30), resting heart rate (74±10 bpm, r=0.14), REE (1615.9±266.7 kcal/d, r=0.29), insulin (11.3±19.3 IU/mL, r=0.38), alkaline phosphatase (76.4±25.1 IU/L, r=0.16), BMA (1778.9±157.2 cm2, r=0.16), and body cell mass (28.2±6.2 kg, r=0.31). Leptin was negatively correlation with maximal METs during the graded exercise test (5.9±1.3, r= -0.13). Leptin was not significantly correlated with age (44.0±12.2 yrs, r=-0.08), height (64.3±2.7 in, r=0.06), resting SBP (124.6±14.3 mm/hg, r=0.04), resting DBP (81.3±9.0 mm/hg, r=0.00) serum triglycerides (139.0±87.3 mg/dL, r=-0.02), total cholesterol (197.1±40.1 mg/dL, r=0.02), HDL (51.4±12.6 mg/dL, r=-0.06), LDL (117.5±34.0 mg/dL, r=0.05), CHL/HDL (3.9±1.0, r=0.01), uric acid (4.8±1.2 mg/dL, r=0.08), glucose (99.2±21.9 mg/dL, r=0.03), BUN (13.6±5.7 mg/dL, r=-0.04), creatinine (0.9±1.4 mg/dL, r=-0.06), BUN/Cre (16.3±4.9, r=-0.08), BMC (1792.0±276.1 g, r=0.12) or BMD (1.0±0.1 g/cm2, r=0.05). CONCLUSIONS: Leptin levels show to be positively related to common health variables related to obesity and negatively correlated to fitness levels. It would be of interest to examine the leptin trends over time during a weight loss program for overweight or obese individuals. Supported by Curves International, Waco, TX
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